Anthem Claim Dispute Form For Experian In Fulton
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FAQ
Documents may be uploaded for online disputes at Experian/upload or submitted by mail. When submitting documents, please only submit copies of documents and not originals. Documents will not be returned to you following the investigation.
If a dispute involves a lack of a decision, it must be submitted within 365 days, or the time specified in the provider's contract, whichever is greater, after the time for contesting or denying a claim has expired.
Important Note: You must submit your appeal within 180 days of the date on the Adverse Benefit Determination or denial letter.
By mail: You can dispute without a credit report by writing to Experian, P.O. Box 4500, Allen, TX 75013. (Printing out Dispute by Mail instructions can streamline the process; you can also scan the completed form and submit it electronically to Experian/upload).
Timely filing is when an insurance company put a time limit on claim submission. For example, if a insurance company has a 90-day timely filing limit that means you need to submit a claim within 90 days of the date of service.
If you think we have made a mistake in denying your medical service, or if you don't agree with our decision, you can ask for an appeal. You must do this within 60 calendar days from the date on the Notice of Action sent to you. We will resolve your concerns within 30 days of receiving your complaint.
Claim forms are available by logging into the member website at blueshieldca or by contacting the benefit administrator. Please submit your claim form and medical records within one year of the service date.
When complete, please mail to: Attn: Grievance and Appeals Department, Anthem Blue Cross, P.O. Box 60007, Los Angeles, CA 90060-0007. For claim disputes, please use the Provider Dispute Resolution form. This information is part of the permanent record. Write clearly and legibly.
Send this claim to: Blue Shield of California, P.O. Box 272540, Chico, CA, 95927-2540.
By mail: You can dispute without a credit report by writing to Experian, P.O. Box 4500, Allen, TX 75013. (Printing out Dispute by Mail instructions can streamline the process; you can also scan the completed form and submit it electronically to Experian/upload). What Happens After You Submit Your Dispute?
